Medical practioners

Medical practitioners 1

Practitioners

In Britanin, doctors, also known as medical practitioners, must be qualified: have a university degree in medicine. They must also be registered – included in the Genreal Medical Council’s list, or register – in order to practise. A doctor who treats patients, as opposed to one who only does research, is called a clinician. A doctor who provides primary care for patients is known as general practitioner (GP), or family doctor. GPs usually work in group practice. Larger group practices work in a buiding called a health centre.
Note: In British English, the verb is spelt practise, and the noun is spelt practice.
Specialties
Specialist doctors, for example paediatricians, generally work in hospitals. However, those who work outside the NHS, providing private health care, may have consulting rooms outside a hospital – for example in the famous Harley Street in London.
The two main branches of medicine are surgery and internal medicine, and the doctors who practise these branches are called surgeons and physicians, respectively. In Britain, male surgeons are addressed as Mr and females as Ms – so Dr Smith is physician, and Ms Smith is a surgeon.
Notes: Names of specialties usually end in –ology; names of specialists usually end in –ologist. If the name of a specialty ends in –ics, the name of the specialist ends in –ician. There are some exceptions, e.g. anaesthetics and anaesthetist.
Choosing a specialty
Jill Mathews has just graduated from medical school and is talking about her future.
“I haven’t decided what to specialize in yet. I need more experience before I decide, but I’m quite attracted to the idea of paediatrics because I like working children. I’d certainly prefer to work with children than, say, elderly patients – so I don’t fancy geriatrics. I was never very interested in detailed anatomy, so the surgical specialties like neurosurgery don’t really appeal. You have to be good with your hands, which I don’t think is a problem for me – I’ve assisted at operations several times, and I’ve even done some minor ops by myself – but surgeons have to be able to do the same thing again and again without getting bored, like tying off cut arteries and so on. I don’t think that would be a problem for me, but they need to make decisions fast and I’m not too good at that. I like to have time to think, which means surgery’s probably not right for me.
Note: The collocation good with is followed by a noun – He’s good with children. The collocation good at is followed by the –ing form (gerund) of a verb, or by a noun – She’s good at explaining procedures. She’s good at explanations.

SOURCE: Professional English in Use – Medicine, Eric H. Glendinning & Ron Howard, CAMBRIDGE 2007.

Medical practitioners 2

Hospital staff
The people who work an any type of workplace, including hospitals, are called the staff. The medical staff in a British hospital belong to one of four main groups:
A pre-registration house officer (PRHO), or house officer, is a newly graduated doctor in the first year of postgraduate training. After a year, he or she becomes a registered medical practitioner. In the current system of training, the Foundation Programme, the name for these junior doctors is Foundation Year 1 doctor (FY1).
A senior house officer (SHO) is in the second year of postgraduate training. The title is now Foundation Year 2 doctor (FY2), but the old terms senior house officer and SHO are still used.
A specialist registrar (SpR) is a doctor who has completed the Foundation Programme, and is training in one of the medical specialties. There are also some non-training registrars-doctors who have completed their training but do not wish to specialize yet.
A consultant is a fully qualified specialist. There may also be some associate specialists – senior doctors who do not wish to become consultants. In addition, there is at least one medical (or clinical) director, who is responsible for all of the medical staff.
Medical teams
Consultant physicians and surgeons are responsible for a specific number of patients in the hospital. Each consultant has a team of junior doctors to help care for those patients. In many hospitals, there are multidisciplinary teams which consist not only of doctors but also of physiotherapists and other allied health professionals.
When patients enter – or are admitted to – hospital, they are usually seen first by one of the junior doctors on the ward where they will receive treatment and care. The junior doctor clerks them – takes their medical history – and examines them. Some time later, the registrar also sees the patients, and may order investigations or tests, for example X-rays or an ECG, make a provisional diagnosis, and begin treatment. The consultant usually sees the new admissions – people who have recently been admitted to the ward – for the first time on one of the regular ward rounds, when the management of the patients is discussed with the registrar. Consultants also decide when a patient is ready to be discharged (sent home). On the ward round, the consultant is accompanied by the team and nurse, and they visit all the patients in the consultant’s care.
Shifts
Junior doctors now normally work in shifts, which means they normally work for eight hours every day, for example 7 am to 3 am, and are then free until 7 am next day. After a week they change to a different shift, for example 3 pm to 11 pm or 11 pm to 7 am. The alternative system is to work from 9 am to 5 pm every day and to take turns to be on call – available to return to the hospital if necessary – from 5 pm to 9 am the next day. Days on call are set out in a rota, or list of names and times. Doctors on call carry a radio pager, or bleeper, a device which makes a nosie when someone is trying to contact them.

Nursing grades
Nurses working in a hospital have the following grades:
Student nurse a nurse who is still in training
Staff nurse a nurse who has completed the training course
Charge nurse a more experienced nurse who is in charge of, or responsible for, a ward or department
Nurse manager a nurse who is in charge of several wards

Support workers
The clinical support worker, who has done a short course and obtained basic qualifications, and the nursing auxiliary, who is usually unqualified, both assist nursing staff. There may also be ward clerks, whose duties include making sure patients’ notes and information are up to date, and answering the phone.
Specialization
Like doctors, nurses can specialize:
A midwife has specialized from the beginning by doing a course in midwifery, the management of pregnancy and childbirth.
District nurses visit patients in their homes.
Health visitors also work in the community, giving advice on the promotion of health and the prevention of illness.
The nurse’s role
The nurse’s role has changed considerably in recent years. In addition to general patient care, checking temperatures, pulse rates and blood pressures, changing dressings, giving injections and removing sutures, nurses now do some of the things previously reserved for doctors, such as prescribing drugs, and ordering laboratory tests. More responsibility for nurses is planned.


SOURCE: Professional English in Use – Medicine, Eric H. Glendinning & Ron Howard, CAMBRIDGE 2007.

Everyday medical English

Poisoning
Accidental poisoning to which people may be exposed, as well as poisoning with suicidal intent, is very frequent.
When such case occurs, the best course for those who want to help is to have the patient transported to the hospital for examination and treatment. Nevertheless some general emergency measures should be known to the public since emergency room facilities may not be readily available. When corrosives such as strong alkalies or acids have been ingested the best initial treatment is direct towards neutralization, dilution, or inactivation.
When strong acids have been ingested, milk or magnesia, milk, egg, albumin, or flour in water can be used.
Alkaline carbonates are contraindicated because they release carbon dioxide when in contact with acids, which, on expansion, may add to the lesions of mucous membranes.
Four strong alkalies, a mixture of equal parts of vinegar and water or diluted citrus juice may be taken as a neutralizer.
Vomiting should never be induced whenever alkalies or acids have been ingested because it may cause esophageal rupture.
Irritant hydrocarbons such as kerosene, turpentine and gasoline frequently induce vomiting when ingested and the danger that these substances might be aspirated during vomiting is very great, since they are very irritating to the lungs. Therefore in these cases vomiting is likewise contraindicated. For practically all other ingested poisons, prompt emptying of the stomach is the principal emergency measure. It is done by induced vomiting or gastric lavage. Vomiting can be induced by inserting a finger in the back of the throat or by taking an emetic followed by several glasses of water or milk.

Vocabulary
Mucous membrane – sluznica
Lavage – ispiranje
Hydrocarbons – ugljeni hidrati
Corrosive – sredstvo koje nagriza, koroziv
Neutralization – neutralizacija
Dilution – razređivanje
Milk of magnesia – lek za suzbijanje želudačne kiseline
Egg albumen – belance od jajeta
Alkaline carbonates – alkalni karbonati (na primer: soda bikarbona ili natrijum karbonat)
Lesion – ozleda, povreda
Kerosene – petrolej za rasvetu
Turpentine – terpentin
Gasoline – benzin (za pogon motornih vozila)

SOURCE: From the book Emergency Room Care, by 26 authors, Edited by Charles Eckert, M.D., Little, Brown and Company (Inc.), Boston, 1967, 1971. / ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

The simple faint
Of all cardiovascular emergencies the most common one is the simple faint, and it is also the most spectacular. Under appropriate conditions no one is immune to this form of syncope.
Factors contributing to fainting are anxiety, fatigue, hunger, dehydration, blood loss, sedation, antihypertensive drugs, excessive heat, pain or prolonged standing – indeed virtually any noxious stimuli. It is a usual occurrence in any emergency room, since the patient and his friends and relatives are all potential fainters.
The mechanism of the faint is thought to be a massive vagal discharge with inappropriate peripheral vasodilatation. Typically the fainter becomes visibly anxious and uneasy; his skin pales and he breaks out into a clammy sweat; he may yawn; there are gastrointestinal rumblings and perhaps the passage of flatus.
Finally, abruptly, consciousness is lost. The appearance of the fainter is frighteningly deathlike. The pulse is strikingly slow and the blood pressure very low. There may be mild anoxic convulsive movement. Unless he is restrained from falling, the collapse is selfrestorative because it brings the heart and the brain to common level. Indeed every effort should be made to lower the fainter to the floor or to some flat surface. Maintenance of the upright position could conceivably result in anoxic brain damage. In recumbency, consciousness soon returns, but it is likely to be lost again if the fainter tries immediately to stand.

Vocabulary
Vagal discharge – pražnjenje vagusa
Vagus – vagus
Peripheral vasodilatation – širenje perifernih krvnih žila
Dehydration – dehidratacija, gubitak tečnosti
Antihypertensive drugs – lekovi za suzbijawe krvnog pritiska
Sedation – stanje smanjene funkcionalne aktivnosti
Noxious – štetan
Gastro-intestinal rumblings – krčenje u želucu I crevima
Yawn – zevati
Strikingly – napadno
Conceivably – razumljivo, eventualno
Recumbency – ležeći položaj

SOURCE: From the book Emergency Room Care, by 26 authors, Edited by Charles Eckert, M.D., Little, Brown and Company (Inc.), Boston, 1967, 1971. / ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Nurses’ notes
If nurses’ notes are detailed and thorough, a high quality of medical and nursing care will be achieved since they will aid the physician as well as nursing personnel in the management of the patient.
It is insufficient to say “the patient had a good day” and it reveals an incomplete appraisal of the patient and his problem to say “the patient spent a restless night”. If the nurse is really interested and dedicated in helping the patient, she’ll write down all the observations pertinent to the patient’s condition.
The patient may have a single disease with secondary or minor additional problems or a number of disorders. The problem may be a symptom of unknown origin. The nurse’s first note in the chart should, therefore, attempt to define this by her personal assessment of the patient’s needs and condition. An example of a nurse’s initial note for a urologic patient is as follows: “Mr. Adams was admitted on 6 East at 5 a.m. via the emergency room per cart. He states he received medication for pain in the right lower back thought to be due to a kidney stone. His clean voided two glass specimens of urine have been sent to the laboratory for analysis and culture. The patient appears oriented and has been instructed as to laboratory tests, X ray exams, and procedure for straining urine. He states he is willing to cooperate. “
“9 p.m. Mr. Adams had a severe pain in the right genital region at 8 p.m. and subsequently voided a small white stone with relief of pain. The stone has been saved for Dr. Johnson. The patient seems quite relieved of his previous anxiety and is joking with ward personnel.”
These brief but fact-filled notes indicate a clear picture of the patient’s problem and subsequent course of action.

Vocabulary
Insufficient – nedovoljan
Nursing personnel – sestrinsko osoblje
Appraisal – procena
Pertinent – koji se odnosi
Disorder – poremećaj
Origin – poreklo
Assessment – provera, procena
Per cart – na kolicima
Void – prazniti
A clean voided specimen of urine – sterilno dobijen uzorak mokraće
Strain urine – filtrirati mokraću (kod sumnje na kamenje u bubregu)
Relief of pain – olakšanje bola

SOURCE: From the book Sawyer's Nursing Care of Patients with Urologic Diseases, by Chester C. Winter, M.D. F.A.C.S., Marylin M. Roehm R.N., B.S., The C.V. Mosby Company, Saint Louis, 1968. / ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Measurement of visual acuity
Determination of visual acuity is often the responsibility of the office or clinic nurse. The ease and speed with which visual acuity may be measured tends to mislead lay persons into underestimating the value of this test. As a matter of fact, the most useful single test of ocular function is the evaluation of visual acuity.
Reduced acuity will reveal the presence of a great variety of eye diseases as well as the need for refractive correction.
Determination of visual should be a part of every complete physical examination and is obligatory when the patient complains of visual blurring or other ocular symptoms.
Distance acuity is measured with the aid of a chart, and the denominator is the distance at which a normal eye could read the line. Thus, 20/30 means that the patient is 20 feet from the chart and can read a line which a normal eye should see at 30 feet.
20/200 means that he can read only the largest letter at the top of the chart, ordinarily legible to a normal eye at 200 feet.
Lesser visual acuity than this may be recorded as hand movement (H.M.) or light perception (L.P.). An eye is not termed “blind” unless it cannot even perceive light.

Vocabulary
Measurement of visual acuity – merenje oštrine vida
Determination of visual acuity – određivanje oštrine vida
Evaluation of visual acuity – ocenjivanje oštrine vida
Refractive correction – zamućenje vida
Record – registrovati

SOURCE: From the book Nursing Care in Eye, Ear, Nose and Throat Disorders William H. Saunders, William H. Haveber, Carol J. Fair, Josephine T. Hickey, the C.V. Mosby Company, Saint Louis, 1968. / ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Everyday medical English

The aphasic patient
The adult who is aphasic encounters many frustrating situations during his or her recovery. Professional people often impose on him useless drills and procedures patterned for children or mentally retarted persons which seldom help him to communicate and often add to his frustration.
Often these approaches are used because the results of research on aphasia are unknown.
A recent survey in which 50 aphasic patients who have recovered a useful level of speech were interviewed, produced interesting information.
All participants in the survey stated that they understood what was said in their presence much sooner than was believed according to literature.
They reported that they were traumatized by much that they heard. “They talked about me as if I weren’t there,” said one of those interviewed, or “as if I were dead”.
The aphasic patients all thought that they would have achieved successful communication earlier if the speakers had spoken more slowly. One patient said that when conversation was too fast “it was just noisy to me”.
All interviewed persons agreed that everyone asked too many questions at one time. The person with aphasia is often unable to formulate a reply under optimal conditions. Any interfering stimulus such as a second question or even a repetition of the first can prevent him processing an answer. Their genereal impression was that no one waited long enough for an answer. The patients cited numerous signs of impatience from those around them which hurt their feelings and affected their morale and motivation to cooperate.

Vocabulary
Aphasic patient – pacijent koji ne može da formuliše reči i ideje zbog ozleda moždane kore
Encounter – naići na
Impose (on) – nametati
Mentally retarted – umno zaostao
Survey – anketa
State – navoditi, iznositi
Traumatize – ozlediti, potresti
Trauma – trauma, duševni potres
Interfere – ometati, upletati se u nešto
Interfering – koji se upliće
Stimulus – nadražaj
Process – prerađivati
Morale – moral, pouzdanje

SOURCE: From American journal of nursing, The Aphasic Patient / AN ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, ŠKOLSKA KNJIGA 2000.

The menopause
The menopause is a time in life that manz women dread. It is surrounded with ignorance and exaggerated stories and many women do not know what to expect. Because of this the nurse is often asked for advice.
Menopause is the cessation of menstruation, which is due to absence of ovulation because of changes in hormonal balance. It is accompanied by symptoms known as „climacteric“. They may start two or three years before the menstruation ceases and continue for a year or so afterwards. It occurs around the age of fifty, although some women may experience it at forty while others as late as fifty five.
The symptoms are brought about by the sudden decrease of oestrogen level and may be heralded by a feeling of emptiness and exhaustion. Hot flushes are one of the most unpleasant symptoms caused by sudden vasodilatation of the blood vessels supplying the skin.
This may cause a great deal of embarassment as the woman feels she is observed by others, which is often not true and a quick glance in the mirror can do much to reassure her.
Headaches and occasionally giddiness may be present. There is usually some weight gain at this period of time, which adds extra burden to the spine and feet and leads to a back ache and fallen arches.
The woman tends to be highly sensitive, her feelings are easily hurt, and she is prone to bouts of weeping. She is often depressed. Tolerance and affection from her family and a little help around the home will do much to reassure and support her at a difficult time.

Vocabulary
Cessation – prestanak
Bring about – uzrokovati
Vasodilatation – proširenje krvnih žila
Ovulation – sazrevanje i izbacivanje ženskog jajašca
Oestrogen – estrogen, vrsta ženskog hormona
Herald – oglasiti, heralded by – praćeni
Embarrassment –neprilika, embarrass - staviti u nepriliku
Reassure – utešiti, umiriti
Giddiness – vrtoglavica
Weight gain – dobijanje na težini
Weight loss – gubitak na težini
Fallen arches – spuštena stopala

SOURCE: From the book Obstetric and Gynaecological Nursing, Rosemary E. Bailey, Bailliere, Tindal and Cassel Ltd., London, 1974. / AN ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, ŠKOLSKA KNJIGA 2000.

HIV and AIDS
1. What are HIV/AIDS?
HIV stands for “Human Immunodeficiency Virus”, a virus which has the ability to attack the immune system and make the body more vulnerable to infections.
AIDS stands for “Acquired Immuno Deficiency Syndrome”, which is a name to cover what happens when the body becomes more vulnerable to infections.
You do not catch AIDS. Initially, you catch HIV which leads to AIDS.
People who develop AIDS become ill from variety of problems which they cannot fight off and from which they eventually die.
Two illnesses which commonly affect AIDS patients are:
- a type of pneumonia called pneumocystitis carinii, and
- a form of cancer which attacks the skin called Kaposi’s sarcoma.
It is possible to carry HIV virus without having AIDS itself. People have been known to carry the virus for up to ten years or more before developing AIDS.
2. How do you catch HIV?
Because of the conflicting publicity about AIDS, people are naturally confused about how easy it is to catch the virus.
It is, in fact, very difficult to catch HIV, other than through the recognized risk behaviours.
Medical opinion is that you cannot catch HIV through normal day-to-day contact with a person carrying the virus.
It is safe to share cups, plates and cutlery. Food prepared under normal hygenic conditions by a person with HIV cannot carry the virus. However, implements such as toothbrushes or razors which come into contact with the blood and bodily secretions may not be safe.
Since the virus has been found in bodily fluids including blood, semen, vaginal secretions, urine, menstrual blood, faeces and breast milk, the virus may be contracted from a person with HIV in the following ways:
- through high-risk sexual practices – unprotected vaginal or anal sex (homosexual and heterosexual),
- through sharing hypodermic needles and drug equipment (as intravenous drug abusers do),
- from an infected mother to her child,
- through transfusions with contaminated blood or some blood products.

SOURCE: AN ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, ŠKOLSKA KNJIGA 2000.

Everyday medical English

Skin care
The nurse can contribute to the prevention of skin disease by teaching good care of the normal skin and by encouraging people to seek medical attention for abnormal skin conditions.
The old saying that cleanliness is next to godliness is probably not entirely true. People from cultures which do not have a high standard of cleanliness do not necessarily have more skin disease than others. The outer layer of skin cells and perspiration are acid in reactions, and their presence inhibits the life and growth of bacteria. Strong soaps that are alkaline in reaction may neutralize this protective acid condition of the skin. They may also remove the oily secretion of sebaceous glands, which lubricate the outer skin layers and contribute to their health.
The skin should be washed often enough to remove dead skin and oily secretion, since these substances have an unpleasant odour after undergoing bacterial decomposition, but not often enough to cause drying and irritation. There is a great deal of individual variation in the bathing necessary to ensure cleanliness, without causing skin irritation. The person who has an oily skin and perspires freely may need to bathe twice daily in warm weather and wash his/her face several times, whereas the person who has a dry skin may have to use creams and lotions to protect her/his skin even when she/he bathes only once a day. Skin secretions are decreased during cold weather so that most people need to use protective creams or lotions to prevent skin irritation at this time.

Vocabulary
Cleanliness – čistoća
Godliness – pobožnost
Sebaceous glands – lojne žlezde
Lubricate – podmazivati
Skin layer – sloj kože
Contribute – pridoneti
Secretion – lučenje
Odour – miris
Perspire freely – obilno se znojiti

SOURCE: From the book Medical-Surgical Nursing, Kathleen Newton Shafer, Janet R. Sawyer, Audrey M. McCluskey, Edna Lifgren Beck, the C.V. Mosby Company, Saint Louis, 1967. /AN ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Work in a mental hospital
Anna is a third year student nurse. At present she is doing her term in a mental hospital.
Today she has been assigned to a new ward. At the moment she is being instructed by the sister tutor how to deal with a severe case of depression.
Sister tutor: You’ll find Mr. Briggs completely unresponsive to any attempts to communicate with him.
Anna: Hardly a cheerful prospect, is it?
Sister tutor: Nevertheless being an observant girl, you may find out what type of activity or conversation seems to help him. Don’t be overcheerful or openly solicitous though, it may be upsetting to a depressed patient.
Anna: I see, I’ll have to find a way to offer the patient at least some emotional comfort.
Sister tutor: That’s right and bear in mind that he needs human contact even though he may seem not to notice it. If there is only one person who consistently cares for such a person, this fact alone may be enough to prevent him from considering suicide as the only means of escape.
Anna: I have noticed that he wants someone to be concerned about his welfare but is unable to ask for help openly.
Sister tutor: Your observations are correct. He wishes to be protected from himself. In contemplating suicide he does not really want to die but to express urgency of escape from an unbearable situation.
Anne: Is it true that person who talk about suicide rarely attempt it?
Sister tutor: No, it’s a very dangerous belief. At least a third of those committing suicide talk about it or give some indirect indication of their intention. So watch him closely, Anna, and make a note of everything he says or does.
Anna: You needn’t worry, sister. If he says anything of the kind I’ll report the fact at once to the doctor on duty.
Sister tutor: By the way, he’ll need complete physical care to sustain him and a lot of serious and sympathetic concern.
Anna: That goes without saying, sister, and thank you very much.

Vocabulary
Be unresponsive – ne reagovati
Be solicitous – biti zabrinut
Contemplate suicide – pomišljati na samoubistvo
Attempt suicide – pokušati samoubistvo
Commit suicide – počiniti samoubistvo
Sister tutor – sestra nastavnica

SOURCE: Adapted from the book Medical-Surgical Nursing, Kathleen Newton Shafer, Janet R. Sawyer, Audrey M. McCluskey, Edna Lifgren Beck, the C.V. Mosby Company, Saint Louis, 1967. /AN ENGLISH READER – MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Everyday medical English

Why eyes water
While hay is perhaps the most common cause, watery eyes can be caused by almost anything. The sun glare can be painful and the eye responds by producing tears from the lacrimal glands. Extreme cold may sting the very sensitive membrane at the front of the eye, the cornea, and have the same effect. In fact, any irritation of the membrane, or the one lining the white of the eye and the inside of the lids, will bring tears. Extreme emotion, cutting an onion, sensitivity to make-up, a high wind, sudden pain in the body, all can cause watery eyes. So, of course, can an eye or lid infection, because these inflame the tiny duct at the nose end of the bottom lid where the tears drain through into your nose. This duct may occasionally get plugged by, for example, a detached eyelash, and will need syringing out. But, it is far more likely that running eyes are due to an allergy. Finally, gritty, sore and watery eyes can be due to city pollution. Treatment for what the doctors call “the urban eye” is just – a weekend in the country!
How should eye drops be dispensed
Remember that any eye drops should be discarded immediately after a course of treatment. If infection has been diagnosed, make sure that the dropper never touches either the eye or anything other than a sterile inside of the bottle in which it is dispensed.
In hospitals, eye treatments are usually dispensed in single eye doses in case of cross infection.
Bathing the eyes with sterile sodium chloride (common salt) eye lotion to clear a foreign body or debris from an infection is best carried out by a trained nurse or doctor.

Vocabulary
Respond – reagovati
Get plugged – začepiti se
Syringe out – ispirati špricem
Bath the eye – isprati oko
Carry out – izvesti, izvršiti
Dispense treatment – vršiti tretman
By means of – pomoću
Course of treatment – tok lečenja
Debris – otpadne materije

SOURCE: AN ENGLISH READER MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.


Giving an injection
Anna, a second year student nurse is facing her second assessment in practical work. Today her proficiency in giving hypodermic injections will be assessed.
Ward sister: Is your tray ready, Anna?
Anna: Oh, I think so, let me check once more – yes, the syringe, two needles, the file, swabs, receiver and ampoule.
Ward sister: You’d better put a forceps on the tray and an extra syringe.
Anna: But this is a ready-to-use syringe with the needle attached. It came in a sterile pack right from the Central sterile supply unit.
Ward sister: So I see, but then I’ve seen the piston stuck many times and you wouldn’t want it to happen to you on such an important occasion, would you?
Now I want you to tell me how you’re going to proceed step by step.
Anna: First I am going to open the ampoule with a file and draw the right dose and then I’ll check the cylinder for air, clean the injection site, pinch the skin and pierce with the needle in an upward direction. Then I’ll make sure that the needle has not entered a blood vessel.
Ward sister: And how will you check that last item?
Anna: Oh, by pulling the piston back a little. The needle is then withdrawn and the injection site swabbed.

Vocabulary
Assessment – provera znanja
Proficiency – veština
Hypodermic – potkožan
Piston - klip šprica
File - pilica
Swab – tufer vate, vata na štapiću
Receiver – posuda za upotrebljeni materijal
Ampoule – ampula

SOURCE: Adapted from “Nursing” by Donald Dallas, Collier – Macmillan Ltd., London, 1971. / AN ENGLISH READER MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Blood pressure
Almost everyone agrees that blood pressure readings should be taken regularly, that high blood pressure is dangerous and must be lowered to normal values.
Blood pressure testing – the act of having the cuff placed on the arm and inflated – makes people anxious, and this alone may elevate the reading above what it would normally be. In order to minimize this fear, leave the cuff on for a while before inflating it.
This permits the patient to become accustomed to it. Then pump up the cuff around the arm, compressing the artery beneath it. When you listen with the stethoscope over the artery in the angle between the arm and the forearm, you hear no sound because there is no blood flowing through due to the inflated cuff. Then slowly release the air in the cuff, decompressing the underlying artery and allowing blood to flow through it once more. The point at which you first hear pulse or beat coming through is called the systolic blood pressure. As the air continues to leave the cuff, the point at which the pulse is no longer heard is called the diastolic pressure.
Blood pressure is expressed as the systolic pressure (the top figure) over the diastolic pressure (or lower number). A typical blood pressure reading is 130 (systolic) over 80 (diastolic) and is written 130/80 mm Hg. Mm Hg simply means the height in milimetres to which the pressure in the cuff will raise the mercury column.

Vocabulary
Blood pressure reading – očitavanje krvnog pritiska
Elevate – podići, povisiti
Inflate – naduvati, napumpati
Mercury- živa
Mercury column – stubac žive
SOURCE: AN ENGLISH READER MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Emergency childbirth
The nurse is often anxious in case her assistance should be sought when a woman suddenly delivers in a public place or in a nearby home. There is little she need do, but an air of calm and the removal of unnecessary people are the first essentials. The baby will deliver itself without assistance. Lay the mother down, remove unnecessary clothing and note the time of birth. The eyes of the child should be wiped and air passages cleared with a clean handkerchief, the baby wrapped in something warm and placed between the mother’s legs. Do not cut the cord. Unless there is bleeding, leave the placenta alone; if it slides out of the vagina it can be wrapped up and left beside the baby. If bleeding does occur lay a hand on the abdomen just above the umbilicus and try to identify the uterus. Having found it massage until it becomes firm; the bleeding should then cease. On no other occasion should the abdomen be touched as this might cause bleeding. The mother and baby should be transferred to hospital by ambulance as soon as possible.

Vocabulary
Deliver – poroditi
Delivery – porođaj
Placenta – posteljica
Umbilicus – pupčana vrpca
Uterus – materica
Vagina – vagina

SOURCE: Adapted from the book „Obstetric and Gynaecological Nursing“ by Rosemary E. Bailey, Bailliere, Tindall and Cassel Ltd. London, 1974. / AN ENGLISH READER MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

The patient with burns
The nurse may be called upon to assist with injuries at the scene of the fire. If the victim’s clothing is on fire, his first panic reaction is to run, which only fans the flame. Rolling the burning person in a blanket on the ground to exclude oxygen, and so putting out the fire, is one of the best procedures. The person whose clothing is on fire should never stand since this increase the danger of breathing flames, heat and smoke into the lungs.
As soon as the burning clothes are extinguished, the patient should be transported to the hospital. A layman or nurse should assume that all burns are more severe than they appear to be.
While awaiting transportation to hospital facilities, the patient should be kept quiet and in a lying position. Loss of natural body heat may be prevented in part by covering the victim with blankets, coats or whatever is available. If clothing sticks to the burned surfaces it should not be removed. Exposed burned surfaces should be covered with sterile dressings or with the cleanest material available. Oils, salves and ointments should not be used on burns.
If the distance to reach medical aid is long and the burn is not too extensive, warm fluids (preferably containing salt) may be given by mouth, provided the patient can tolerate them.
Pain in extensive burns is best controlled by gentle and minimal handling and by application of dressing to exclude air.
Occasionally deep, third degree burns are almost painless, since nerve endings have been destroyed, and for the first few minutes the patient may appear not to be badly affected.

Vocabulary
Facility – sredstvo koje omogućava da se nešto uradi, da se obavi neka radnja
Be called upon – biti zamoljen, pozvan
Layman – laik
Sterile dressing – sterilni zavoj
Salve – lekovita mast, balzam
Ointment - mast

SOURCE: from the book Medical Surgical Nursing, Kathleen newton Shafer, Janet R. Sawyer, Audrey M. McCluskey, Edna Lifgren beck, the C.V. Mosby Company, Saint Lois, 1967. / AN ENGLISH READER MEDICINE, Sunita Bujas & Vesna Margan, Školska knjiga 2000.

Humans as mammals

Humans as mammals
Our species belongs to category of mammals known as primates. Nearly all primates are tree-dwellers, and most are confined to the belt of warm forest that girdles our planet between the tropics. Many aspects of human anatomy – for example, our grasping hands, forward-facing eyes, and color vision – are typical primate features, vestiges of millions of generations spent clambering through trees. And we are unmistakably primates in our social lives and behavior: like many monkeys and apes, we live in complex, hierarchical societies where survival depends on navigating an ever-changing web of social relationships.
Being human
It is common knowledge that we share nearly all our genes with chimpanzees. Yet the tiny fraction that makes us different has a profound effect on our anatomy., so much so that, for centuries, scientists had difficulty believing we had evolved from apes at all. Unlike other apes, we lack the opposable (flexible) big toes needed for climbing, and we get around by walking on outsized hind limbs with our short forelimbs dangling in the air. Compared to apes, our skin is almost naked, our skeleton is bent out of shape, our head is swollen like a balloon, and our breasts and penis are bizarrely large. Even so, if alien scientists were to land on Earth and study Homo sapiens, they would have very little difficulty in recognizing us as apes. Physically unusual we may be, but the mountain of similarities between us and the other apes would soon become apparent.
If those visitors were to study human mind, however, they might think that we too had arrived from another planet. In intellectual terms, a yawning chasm separates Homo sapiens from every other species on Earth. We have languages of astonishing complexity. We build cities, cars spaceships. We invented morality, religion, trade, science, world wars. We can think symbolically, create art, plan for the future, and solve problems using our imagination. And, perhaps even better than other primates, we can read each other’s minds and intentions from only the slightest inflection of the voice or dart of the eyes.
Flexible shoulders
Many of the features that make humans special are unique to us, but others are shared with our close relatives. Like other apes, we have flatter chests and longer, more powerful arms than monkeys. These differences evolved because of the way that apes move through the trees. Instead of scurrying along branches on all fours as all monkeys do, apes haul themselves up trees by grasping the trunk in their arms. The shoulder blade of apes are at the back of the chest rather than the sides, which frees up the shoulder joint and allows the arm to reach overhead and swing around. In humans, the flexible shoulders that evolved from climbing are put to other uses. Uniquely, we can throw objects with force and accuracy – an ability that proved enormously useful when our hunting ancestors invented throwable weapons. Flexible shoulders also make our grasping hands more useful. If our shoulders were less mobile, we would find it much harder to carry and manipulate objects.
On two feet
The ability to walk on two feet not only sets human apart from other apes but also marks a major divide between us and the rest of mammals. No other mammal can match our ability to stand, walk and run on two legs. Of course, many other animals are capable of twolegged-or bipedal-movement, including ostriches, kangaroos (although they hop), and penguins. However unlike ostriches and kangaroos, which are counterweighted by long necks and tails that act like a tightrope walker’s pole, humans stay vertical largely because our nervous system is so beautifully coordinated. Our sense of balance also enables us to learn how to ice skate, ski, and even perform feats such as walking on our hands. One price we pay for moving in such a strange manner is that walking takes time for us to master – human baby cannot walk for about a year.
Although other apes cannot walk or run as we can, they show hints of our ability. Apes have more upright posture than monkeys. In trees, they frequently stand on their hind limbs while holding branches with their arms. Chimps and gibbons can even walk – or waddle – a short distance on the ground on two feet, an ability that comes in handy when they need to wade across the river, but one that requires great effort.
Bipedal motion is easy for humans as a result of changes in the skeleton of our ancestors. We can extend our legs fully to form a vertical column that supports the body-s weight, and the knees lock to prevent overextension of the lower leg. In contrast, apes can only partially extend the lower leg, forcing them to stand with their knees bent and rely on muscle power alone to stay upright, which is tiring.
Seen from the front, the human femur (thighbone) slopes inward from the hip to the knee, ensuring that the knees and feet are directly below the body’s center of gravity. Apes’ legs are more splayed, resulting in an awkward waddling gait. Human legs are much larger than our arms, giving our body a relatively low center of gravity that aids stability. Our center of gravity falls between two hips, giving us stable, vertical posture. In contrast, apes have large, muscular arms, short legs, and a high center of gravity results in an unstable, crooked posture when upright.
Our feet are arched so that the heel and the ball of the foot carry our weight as we move. In contrast, apes stand with the whole length of the foot on the ground. Apes have opposable big toes for climbing, but in humans the big toe is aligned with the others. When we walk, weight is transmitted from the heel to the ball of the foot and on to the big toe, which is the last point of contact as the foot pushes off the ground. This is a more efficient way of walking.
The human skull is balanced on top of a vertical spine rather than being held by muscles in front of horizontal spine. As a result, the hole through which our spinal cord passes (the foramen magnum) is shifted forward relative to that of apes, so that it lies directly under the brain. The spine is curved into an undulating S-shape that acts as a spring, absorbing shocks during movement.
To accommodate the enormous muscles that we need for walking- especially the gluteus maximus (buttock) –the human pelvis is much shorter and broader than that of other apes. It is also bowl-shaped to support the abdominal organs cradled above it.
There are drawbacks to being bipedal. One is that childbirth is more painful and protracted in humans than in other mammals. Another is that lower back pain and injury are more common in humans. The vertebrae of the lower back have to carry all the weight of the upper body, yet they must be small to preserve the spine’s flexibility. When we bend over to lift a heavy weight, the lower back is subjected to a force much greater than our body weight, and this force can rupture one of the shock-absorbing disks between the bones (called a slipped disk).

Source: HUMAN (DK, SMITHSONIAN INSTITUTION – Robert Winston, Dr. Don E. Wilson, 2006.)

Human body

UNIT 1
There are many different types of cells in the human body. None of these cells function well on there own and they are part of the much larger systems.
Tissues
Cells group together in the body to form tissues - a collection of similar cells that group together to perform a specialized function. There are 4 primary tissue types in the human body: epithelial tissue, connective tissue, muscle tissue and nerve tissue.
1. Epithelial Tissue - The cells of epithelial tissue pack tightly together and form continuous sheets that serve as linings in different parts of the body. Epithelial tissue serve as membranes lining organs and helping to keep the body's organs separate, in place and protected. Some examples of epithelial tissue are the outer layer of the skin, the inside of the mouth and stomach, and the tissue surrounding the body's organs.
2. Connective Tissue - There are many types of connective tissue in the body. Generally speaking, connective tissue adds support and structure to the body. Most types of connective tissue contain fibrous strands of the protein collagen that add strength to connective tissue. Some examples of connective tissue include the inner layers of skin, tendons, ligaments, cartilage, bone and fat tissue.
3. Muscle Tissue - Muscle tissue is a specialized tissue that can contract. Muscle tissue contains the specialized proteins actin and myosin that slide past one another and allow movement.
4. Nerve Tissue - Nerve tissue contains two types of cells: neurons and glial cells. Nerve tissue has the ability to generate and conduct electrical signals in the body. These electrical messages are managed by nerve tissue in the brain and transmitted down the spinal cord to the body.
Organs
An organ is a structure that contains at least two different types of tissue functioning together for a common purpose. There are many different organs in the body: the liver, kidneys, heart, even our skin is an organ.
Organ Systems
Organ systems are made of two or more different organs that work together to provide a common function. There are few major organ systems in the human body.

SKELETAL SYSTEM
Major Role:
The main role of the skeletal system is to provide support for the body, to protect delicate internal organs and to provide attachment sites for the organs.
Major Organs:
Bones, cartilage, tendons and ligaments.
MUSCULAR/MUSCLE SYSTEM
Major Role:
The main role of the muscular system is to provide movement. Muscles work in pairs to move limbs and provide the organism with mobility. Muscles also control the movement of materials through some organs, such as the stomach and intestine, and the heart and circulatory system
Major Organs:
Skeletal muscles and smooth muscles throughout the body.
NERVOUS SYSTEM
Major Role:
The main role of the nervous system is to relay electrical signals through the body. The nervous system directs behaviour and movement and, along with the endocrine system, controls physiological processes such as digestion, circulation, etc.
Major Organs:
Brain, spinal cord and peripheral nerves.
INTEGUMENTARY SYSTEM
Major Role: The main role of the integumentary system is to cover body with layer of cells which makes skin and keep temperature of body steady and in balance with exterior conditions. Also to receive messages from the outside world and react in response to it.
Major organs:
Skin and senses.
CIRCULATORY, LYMPHATIC/IMMUNE AND ENDOCRINE SYSTEM
Major Role:
The main role of the circulatory system is to transport nutrients, gases (such as oxygen and CO2), hormones and wastes through the body. The main role of the immune system is to destroy and remove invading microbes and viruses from the body. The lymphatic system also removes fat and excess fluids from the blood. The main role of the endocrine system is to relay chemical messages through the body. In conjunction with the nervous system, these chemical messages help control physiological processes such as nutrient absorption, growth, etc.

Major Organs:
Heart, blood vessels and blood; Lymph, lymph nodes and vessels, white blood cells, T- and B- cells; Many glands exist in the body that secrete endocrine hormones. Among these are the hypothalamus, pituitary, thyroid, pancreas and adrenal glands.
RESPIRATORY SYSTEM AND DIGESTIVE SYSTEM
Major Role:
The main role of the respiratory system is to provide gas exchange between the blood and the environment. Primarily, oxygen is absorbed from the atmosphere into the body and carbon dioxide is expelled from the body. The main role of the digestive system is to breakdown and absorb nutrients that are necessary for growth and maintenance.
Major Organs:
Nose, trachea and lungs; Mouth, esophagus, stomach, small and large intestines.
REPRODUCTIVE AND URINARY SYSTEM
Major Role:
The main role of the reproductive system is to manufacture cells that allow reproduction. In the male, sperm are created to inseminate egg cells produced in the female. The main role of the urinary system is to filter out cellular wastes, toxins and excess water or nutrients from the circulatory system.
Major Organs:
Female (top): ovaries, oviducts, uterus, vagina and mammary glands;
Male (bottom): testes, seminal vesicles and penis;
Major organs of urinary system are kidneys, ureters, bladder and urethra.
(Adapted from: http://web.jjay.cuny.edu/~acarpi/NSC/14-anatomy.htm)

UNIT 2
WHERE BONES BREAK
The risk of breaking a bone varies with age and occupation. Children’s bones are more flexible than adults’ and incomplete breaks known as “greenstick fractures” are most common. They frequently occur just above the elbow. In old age bones are more brittle. A mild fall can break the hip. For younger people road accidents and sports involve the greatest risk of breakages.

How a broken arm mends
Blood seeps out of the torn blood vessels. It formes a clot between the broken ends.
Cells in the bone sheath and lining multiply to form a bridge of fibrous tissue.
Within a week, young bone begins to replace the fibrous. By 3-6 weeks the broken ends are linked by bone.
The young bone is replaced by stronger mature bone. By 6-12 weeks the arm can be used again. Over the next year the bone gradually regains its smooth outline in children. A slight bump remains in adults.

UNIT 3
MUSCLES
Altogether the body has about 600 muscles, some large and very powerful, others tiny but precise in action. In a single stride you may use over 100 different muscles. The timing of their actions is perfectly coordinated to make one streamlined movement.
Throughout each movement messages pass along the nerves between muscles and brain. In this way the muscles are controlled with little effort from our conscious minds.

Each muscle is made up of very fine strands of fibres. These contains numerous very fine filaments of two special proteins, actin and myosin. When a muscle fibre gets the signal to contract, the action filaments are pulled along the myosin filaments by electrochemical forces, shortening the muscle.

UNIT 4
THE BRAIN
Inside the human head is a large lump of grayish jelly – it’s called the brain. Here lies the seat of the mind, intelligence and thought. The brain “jelly” is composed of millione of nerve cells which have many branches to receive or transmit information. A single cell may be connected to over 200 others.
All day and night the brain is alive with electrical activity. Messages stream in along the nerves from the eyes, ears, skin, etc. Each message is coded as a series of electrical “bleeps” or impulses.Deeper inside the brain there are centres controlling sneezing, sleeping, hearing and many other activities.
All mental activity depends on many parts of the brain working together. In the simple act of reading aloud one sentence from this book, you would use the centres of visual analysis, hearing, speech, muscle control and various others. The activity of all these regions would be coordinated by numerous connecting nerve cells to produce smooth, clear sound of your voice.

UNIT 5
SKIN
Inside, the skin is made up of two main layers: the epidermis and the dermis. Except on the hand and soles the dermis is very thin, just about 1/10th millimeters deep. At its surface, dead cells are being continually rubbed away, and new cells move out from the living layer inside to replace them.

The dermis is much thicker. It is made up of a meshwork of tough white fibres and springy elastic fibres. Between them run many blood vessels and nerves which are connected to the tiny organs responsible for sensations of touch, pain, warmth and cold.

Hairs are specialized parts of the epidermis and they grow from the base of hair follicles.
The waxy secretion of the sebaceous glands oils the hairs, and also provides food for the follicle mite, a minute spider-like animal that lives ina many people’s eyelashes.

In cold weather tiny muscles pull the hairs upright trapping a film of warm still air around the body. The blood capillaries in the dermis narrow, so that the skin looks pale. In warm weather these cappilaries open fully, to allow more blood to reach the cool surface of the skin, and the sweat glands pour out a clear salty liquid, which evaporates, cooling the body.
In the armpits and genital areas are special sweat glands called apocrine glands, whose products smell strongly under the influence of local bacteria. These may have helped our animal ancestors in sexual attraction. Today, however, man self-consciously suppress them with deodorants.

Birth
At birth baby have a smooth soft skin with very little pigment. A thick layer of fat beneath the skin accounts for the chubby cheeks.

Adolescence
New levels of sex hormones stimulate beard growth in boys and greater activity in the sebaceous glands in both sexes. These may become infected with bacteria, causing pimples.

Middle age
The skin is beginning to show signs of ageing. Furrows from across the brow because of repeated frowning, and where hair pigment production has slowed down, grey hairs appear.

Old age
Wrinkles form as elastic fibres in the dermis lose their “springiness”, and as the production of hair pigment ceases the hair turns white. Though wild whiskers often grow in ears and eyebrows, many scalp follicles produce only fine soft hairs, or cease production altogether, causing baldness.


UNIT 6
CIRCULAR TOUR

The heart is the main pump for the organism. It beats about 70 times a minute.
The left side of the heart deals with oxygen rich blood from the lungs; the right side with oxygen deficient blood from elsewhere. The incoming blood fills the auricles. It is forced
into the ventricles, then into the aorta or pulmonary artery. Valves ensure that the blood does not go the wrong way.
With every beat of a heart about a third of a cup of blood leaves each side of the heart. A single circular journey from the heart to the lungs, back to the heart, out through the arteries to a limb and back to the heart through the veins would take only about half a minute.

UNIT 7
RELEASING ENERGY – RESPIRATION
Once the cells have obtained food, they must be able to release the energy it contains. This is done through respiration. The food substance is gradually broken down and its energy released a little at time. During this ‘reaction’ oxygen is sed up and carbon dioxid left as waste.
Respiration is in many ways like burning of a fire. Burning also requires oxygen and releases energy and carbon dioxide. However, respiration is a slower, less violent process and it takes place at a much lower temperature.
The oxygen needed for respiration is obtained from the air during breathing. The lungs and surrounding parts of the chest pump air in and out of the body. The air coming in is filtered free of dust particles in the nose. It travels down the windpipe to the lungs, then along many branching air passages. In the end it reaches millions of tiny air pockets, or alveoli, surrounded by blood vessels. Oxygen passes through the walls of alveoli into the blood vessels, to be transported around the body.
The very fine air passages in the lungs end up in tiny air sacs or alveoli. Here oxygen enters the bloodstream. Carbon dioxide goes out of the blood vessels into the air sacs and is expelled when air is breathed out.

High in the mountain the air contains less oxygen than down below. The climber breathes faster and deeper than usual. If he stays many weeks in the mountains, his body will make extra haemoglobin to help transport more oxygen.When there is too little oxygen or too much carbon dioxide in the blood, messages are sent from the “breathing centre” in the brain to the diaphragm and chest muscles to raise the rate of breathing.


UNIT 8
GROWING UP
Between nine and fourteen years old of age boys and girls enter a stage called adolescence. The body gradually changes from child-like to adult form. Inside, the reproductive organs begin to mature, so that the person will be capable of having children of his or her own.
In girls these changes start with gradual swelling of the breasts and the growth of hair in the armpits and genital area. Within the next year or two monthly periods begin. In boys the testes enlarge first. Then the moustache and beard develop, the voice breaks and the penis gradually grows to its full size.
All these changes take several years to complete. They are controlled by the brain through chemical messengers called hormones. These are created by reproductive organs and the pituitary gland – the master gland at the base of the brain. Mental changes accompany the physical changes. Gradually boys and girls become attracted to each other, but often experience difficulty in relationships with their parents for a few years.

The menstrual cycle
Once every month the ovaries release a single egg which could develop into a baby. In preparation for this event, the womb grows a new soft lining. If the egg does not meet the sperm within 24 hours of leaving the ovary, it dies. The lining of the womb then breaks down. It is discarded with a little blood during the monthly period. Then the cycle starts again. Just before their periods, many girls feel irritable or find that their skin is more spotty than usual.

The male sex organs
Sperm are produced in the testes which are held in two thin sacs behind the penis. This lets out urine and injects sperm into the woman during intercourse. The seminal vesicles and prostate glands make fluids which help the sperm on their journey.

The female sex organs
The ovaries produce microscopic eggs which travel down the fallopian tubes to a muscular sac called the womb. In pregnant women the womb houses the developing baby. A short tube with stretchy walls, the vagina, links the womb to the outside world.


Source: The Human Body, Janet Noel - Macdonald/Educational 1973.

Cells to systems

Cells to systems
The living structure of the human body is built from different types of cells. Cells mass together in clumps or layers to form tissues, which are specialized for different roles within the body. The cell is fundamental unit of life. We all come into existence as a single fertilized cell that rapidly multiplies. By the time we reach adulthood, however, the cells that make up the body number approximately 75 trilion. Cells also contain DNA – the genetic material that is responsible for our development and our individual characteristics. Some cells last a lifetime; others wear out after a day or so, or fall victim to damage or disease. Cells act together in an organized way in order to function effectively – they communicate with one another via chemical messages.
The variety of cells and cell function
Around 200 different types of cell have been identified in the human body. Cells begin to differentiate, becoming specialized for particular roles, at a very early stage in our development. Cells may differ widely in their external appearance and in their activities, but almost all of them share the same internal components. They also have many basic functions in common.
Cells are busy factories, carrying out several thousand different tasks in an orderly, integrated way. Each type of cell has a specialized role, but most cells are involved in the breakdown of glucose, creating energy to drive their respective activities. Small structures called organelles within each cell carry out the cell’s vital activities, coordinated by the cell’s control center, the nucleus. One important task of organelles is the production of proteins, which are needed to carry out vital biochemical reactions in the body as well as for development and growth. Some organelles are involved in digestion processes while others can destroy dangerous chemicals that may potentially harm the cell.
Types of tissues
Collection of similar cells, and the substances around them, form tissue. There are five man types of tissue: epithelial, connective, skeletal, nervous and blood. Epithelial tissue lines and protects body organs. It is fairly closely packed and occurs in sheets that may be several layers thick. Connective tissue is the supporting tissue of the body, and includes bone, cartilage, and fat. It is more loosely packed than epithelial tissue. The protein collagen is very important in giving connective tissue its toughness. There are three types of muscle tissue. Skeletal muscle is attached to the bone and allows us to make voluntary movements; smooth muscle tissue is involved in involuntary movements; and cardiac muscle is specialized tissue allowing the coordinated beating of the heart. Nervous tissue consists of nerve cells (also known as neurons) that conduct electrical impulses, and supporting cells, called glial cells, which supply the working nerve cells with nutrients and oxygen.
Organs of the body
An organ is a working part of the body, consisting of two or more types of tissue. Human organs include the skin (the largest organ in the body), the heart, the lungs, the stomach, the liver, the kidneys and the intestines. The tissues that make up organs are specialized to perform specific function. The stomach for example needs to be able to churn food and secrete substances that aid digestion. The exterior surface of the stomach’s outer layer, the serosa, consists of a type of epithelial tissue made up of squamous (flattened) cells that protect the stomach against friction during churning. The serosa’s interior layer is connective tissue that supports the epithelial tissue and nourishes the surrounding structures. Three layers of smooth muscle tissue lie inside the connective tissue layer. Each layer of muscle tissue runs at a different angle, providing maximum directional movement for churning. Simple columnar epithelial tissue forms the inner lining of the stomach, called the mucosa. This type of epithelial tissue is made up of tall columnar cells, so that the tissue can lie in rugae (folds) when the stomach is empty and flatten to accommodate incoming food when necessary. The epithelial tissue in the lining of the stomach also houses glands that secrete enzymes and acid to break down food as well as cells that produce protective mucus.
Body systems
Systems of the body are made up of a group of tissue and organs that work together to carry out a specific function or set of functions. For example, the musculoskeletal system consists of bon, muscle, cartilage and tendons, which together provide support for the body and enable us to move. The main functions of each body system are listed in the table below and their components are described on the next page. Systems cannot work alone: each system is dependent on the others to function. For example, all systems in the body are reliant on the cardiovascular system to bring them nutrient – and oxygen-rich blood that provides them with the energy they require to function. The nervous system and the endocrine system are the body control’s systems: they continuously monitor body activities and adjust them appropriately.
BODY SYSTEMS AND THEIR FUNCTIONS
Musculoskeletal:
Provides the framework on which the body is built and facilitates movement. Integumentary:
Provides protection from the environment through the skin, hair and nails.
Respiratory:
Through breathing, supplies fresh oxygen to body tissues and expels carbon dioxide. Lymphatic and immune:
Defend and protect the body from infection and some cancers.
Cardiovascular:
Circulates blood to deliver nutrients and oxygen to all body tissues. Nervous:
Senses the environment; through nerve impulses, monitors and controls body activities.
Digestive:
Fuels the body by food breakdown and processing of nutrients; also removes waste. Endocrine:
Controls the body through the action of hormones secreted by glands and tissues.
Urinary:
Forms urine to rid the body of waste and help maintain its chemical balance. Reproductive:
Makes new bodies through the production of hormones, sperms and eggs.

Source: HUMAN (DK, SMITHSONIAN INSTITUTION – Robert Winston, Dr. Don E. Wilson, 2006.)

Medical vocabulary

www.bbc.co.uk/skillswise/words/vocabulary/wordsforwork/care

www.bbc.co.uk/science/humanbody/body

biology.about.com/od/gamesandquizzes/a/aa061308a.htm

www.englishclub.com/english-for-work/medical-vocabulary.htm

Medical dictionaries and glossary

medical-dictionary.thefreedictionary.com

www.medterms.com

http://www.merriam-webster.com/medlineplus

http://www.medicalglossary.org/anatomy.html

Grammar practice

www.ego4u.com/en
www.englisch-hilfen.de/en/exercises
www.englishpage.com
esl.about.com

Quotations

The greatest mistake in the treatment of diseases is that there are physicians for the body and physicians for the soul, although the two cannot be separated.
Plato

A doctor who cannot take a good history and a patient who cannot give one are in danger of giving and receiving bad treatment.
Author Unknown

A doctor must work eighteen hours a day and seven days a week. If you cannot console yourself to this, get out of the profession.
Martin H. Fischer

Diagnosis is not the end, but the beginning of practice.
Martin H. Fischer

A physician is obligated to consider more than a diseased organ, more even than the whole man - he must view the man in his world.
Harvey Cushing

Never forget that it is not a pneumonia, but a pneumonic man who is your patient.
William Withey Gull

Man is a creature composed of countless millions of cells: a microbe is composed of only one, yet throughout the ages the two have been in ceaseless conflict.
A.B. Christie

He who takes medicine and neglects to diet wastes the skill of his doctors.
Chinese Proverb

Water, air, and cleanliness are the chief articles in my pharmacopoeia.
Napoleon I


Always laugh when you can. It is cheap medicine.
Lord Byron

Stem cell research can revolutionize medicine, more than anything since antibiotics.
Ron Reagan

The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need of a physician.
William J. Mayo


Every tooth in a man's head is more valuable than a diamond.
Miguel de Cervantes, Don Quixote

The heart has no wrinkles.
Marie de Sevigne


Nurses don't wait until October to celebrate Make a Difference Day - they make a difference every day!
Author Unknown

Beauty is only skin deep, but ugly goes clean to the bone.
Dorothy Parker

Medical abbreviations

• A/G ratio: albumin/globulin ratio
• Ac: before meals
• ad lib: at will, as desired
• adm: admission, admitted
• ASAP: as soon as possible
• Bid: twice a day
• Bm: bowel movement
• BP: blood pressure
• BPM: beats per minute
• BRP: bathroom privileges
• c/o: complains of
• C: Centigrade, Celsius
• C02: carbon dioxide
• Cap: capsule
• CC: chief complaint
• cc: cubic centimeter
• Cgh: cough
• CPR: cardiopulmonary resuscitation
• CVS: cardiovascular system
• CXR: chest x-ray
• D&C: dilletation and curettage
• d/c: discontinue or discharge
• DM: diabetes mellitus
• EBL: estimated blood loss
• ECG or EKG: electrocardiogram
• ER: emergency room
• F: Fahrenheit
• Fb: foreign body
• fx: fracture
• gtt: drop-liquid measurement
• H & P: history and physical
• H20: water
• HPC: history of present complaint
• HR: heart rate
• hr: hour
• hs: hour of sleep (bedtime)
• I & O: intake and output
• IDDM: insulin dependent diabetes mellitus
• IM: intramuscular
• IV: intravenous
• mg: milligram
• MI: myocardial infarct
• ml: millilitre
• MVA: motor vehicle accident
• N&V: nausea and vomiting
• NPO: nothing by mouth
• NTG: nitroglycerin
• O/E: on examination
• O2: oxygen
• OD: right eye
• OPA: outpatient appointment
• OS: left eye
• OU: both eyes
• pc: after meals
• PM: post mortem
• PMH: past medical history
• po: by mouth
• post-op: postoperative (after surgery)
• pre-op: preoperative (before surgery)
• prn: as needed
• pt: patient
• qd: every day
• qh: every hour
• qid: four times a day
• qod: every other day
• Rx: prescription, treatment
• s/s: signs and symptoms
• s: without
• sc/sq: subcutaneous
• SOB: short of breath
• stat: immediately
• sx: symptoms
• tab: tablet
• TPR: temperature, pulse, respiration
• U/S: ultrasound
• vs: vital signs
• XR: X-ray

Unit 8

Go to http://kidshealth.org/parent/general/body_basics/female_
reproductive_system.html and
http://kidshealth.org/misc/movie/bodybasics/bodybasics_female_
repro.html to fi nd out about the reproductive system.

Unit 7

Go to http://science.nationalgeographic.com/science/health-
-and-human-body/human-body and read about digestive system.

Go to www.e-learningforkids.org click on health icon and expand and
test your respiratory system knowledge.

Go to www.animated-teeth.com/questions-answers/dentalhealth-
quizzes.htm to expand and test your knowledge about teeth.

Unit 6

Go to http://science.nationalgeographic.com/science/health-and-
-human-body/human-body to fi nd more information about the heart.
Go to www.kidshealth.org/kid/htbw, section endocrine system and
do the quiz to test your knowledge of the endocrine system.

Unit 5

Go to www.kidsskinhealth.org/kids , section How the body works and
fi nd out about integumentary system.

Unit 4

Go to www.bbc.co.uk/science/humanbody/body, section nervous
system and http://faculty.washington.edu/chudler/jeopardy.html to
improve and test your knowledge of the nervous system.

Unit 3

Go to www.bbc.co.uk/science/humanbody/body section muscles to
improve and test your muscular system knowledge.

Go to www.kidshealth.org to fi nd information about our body and health
problems, fi lms and games, medical dictionary and much more.

Go to www.nhs.uk/conditions/physiotherapy to fi nd out some information
about physiotherapy.

Unit 2

Go to www.bbc.co.uk/science/humanbody/body
sections skeleton anatomy and skeleton game to improve
and test your knowledge of skeletal system.

Unit 1

To test your knowledge of organ systems go to
http://biology.about.com/od/gamesandquizzes,
choose the organ system quiz and start the quiz.

Go to www.bls.gov/oco/cg, section career guide index/healthcare
and www.nhscareers.nhs.uk to fi nd more about jobs in health care in the
USA and the UK.